Abstract

    Open Access Research Article Article ID: AOR-5-189

    Diffusion-weighted magnetic resonance imaging with echo-planar and non-echo-planar (PROPELLER) techniques in the clinical evaluation of cholesteatoma

    María Dolores Moreno-Ramos*, Miguel Olivencia Pérez, Juan Antonio Ibáñez Rodríguez, Mª José Gómez Galán and Francisco Javier Ramos Medrano

    Background: Diffusion-weighted magnetic resonance imaging (DWI) is an alternative to second-look surgery for the detection of cholesteatoma.

    Purpose: To assess the utility of DWI with echo-planar (EPI-DWI) and non-echo-planar (PROPELLER) sequences for the diagnosis of primary and recurrent cholesteatoma. 

    Materials and methods: A prospective study of 33 ears, 21 with previous cholesteatoma surgery. Twelve patients were asymptomatic, with 4 showing signs suggestive of cholesteatoma in previous CT scans. The MRI protocol was: axial and coronal T1-weighted and T2-weighted imaging, and diffusion-weighted sequences by both EPI-DWI and PROPELLER techniques. The results were correlated with the clinical examination and subsequent surgical findings. Ten patients undergoing ear surgery for other reasons were included as negative controls.

    Results: The diagnostic accuracy was calculated with the 22 patients who underwent surgery and the negative controls. Both diffusion-weighted sequences showed a specificity of 100%. The sensitivity of PROPELLER was 95%, compared to 20% for EPI-DWI. The latter showed non-specific imaging with bone artefacts, thus making impossible to confirm or exclude the diagnosis. The PROPELLER technique yielded one false negative, compared with 16 by EPI-DWI. Both techniques gave a false negative in one case of a primary cholesteatoma. A positive result was obtained in two patients with no clinical suspicion of recurrence. 

    Conclusions: In contrast to EPI-DWI, PROPELLER is a reliable technique for diagnosing cholesteatoma. As positive results were found in asymptomatic patients, we recommend regular monitoring by PROPELLER, even in the absence of clinical findings.

    Keywords:

    Published on: Feb 11, 2019 Pages: 14-19

    Full Text PDF Full Text HTML DOI: 10.17352/2455-1759.000089
    CrossMark Publons Harvard Library HOLLIS Search IT Semantic Scholar Get Citation Base Search Scilit OAI-PMH ResearchGate Academic Microsoft GrowKudos Universite de Paris UW Libraries SJSU King Library SJSU King Library NUS Library McGill DET KGL BIBLiOTEK JCU Discovery Universidad De Lima WorldCat VU on WorldCat

    Indexing/Archiving

    Case Reports

    Pinterest on AOR